The guideline on Borderline PersonalityDisorder, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence- and consensus-based recommendations for healthcare staff on how to treat and manage borderline personalitydisorder.

The guideline on Antisocial PersonalityDisorder, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence- and consensus-based recommendations for staff working in health and social care and the criminal justice system on how to treat, manage and prevent antisocial personalitydisorder.

Since the 1950s there has been a trend to close institutions of care for people who are mentally unwell. In addition, government policy has sought to reduce the number of hospital beds available in favour of care being provided in the community to enable people to live more independent lives. The aim of Community Mental Health Teams (CMHTs) is to bring a specialist care package to people in the community. We reviewed the available evidence on CMHTs compared with standard non‐team community care. We found only three trials which indicated some benefit in terms of acceptability of treatment, but overall the evidence for CMHTs is inadequate and further trials are needed to determine its effectiveness.

Many people with borderline personalitydisorder (BPD) receive medical treatment. However, there are no drugs available for BPD treatment specifically. A certain drug is most often chosen because of its known properties in the treatment of associated disorders, or BPD symptoms that are also known to be present in other conditions, such as depressive, psychotic, or anxious disorders. BPD itself is characterised by a pervasive pattern of instability in affect regulation (with symptoms such as inappropriate anger, chronic feelings of emptiness, and affective instability), impulse control (symptoms: self‐mutilating or suicidal behaviour, ideation, or suicidal threats to others), interpersonal problems (symptoms: frantic efforts to avoid abandonment, patterns of unstable relationships with idealization and depreciation of others), and cognitive‐perceptual problems (symptoms: identity disturbance in terms of self perception, transient paranoid thoughts or feelings of dissociation in stressful situations). This review aimed to summarise the current evidence of drug treatment effects in BPD from high‐quality randomised trials.

The research evidence for Short-Term Psychodynamic Psychotherapy (STPP) in the treatment of personality disorders (PD) was examined through consideration of studies utilizing randomized controlled designs. An extensive literature search revealed eight published Randomized Controlled Trials (RCT) of moderate study quality. A critical review of this literature is offered to provide an evidence-based guidance for clinicians and implications for treatments are discussed. Preliminary conclusions suggest STPP may be considered an efficacious empirically-supported treatment option for a range of PDs, producing significant and medium to long-term improvements for a large percentage of patients. Further research is recommended to allow comparisons with alternative evidence-based approaches.

INTRODUCTION: Over the past 20 years, several studies have established the efficacy of different forms of psychotherapy for borderline personality disorders (BPD). However, existing research has used a wide range of outcomes measures which makes it difficult to quantify data and to compare interventions. This review has been designed to analyse the evidence from randomized controlled trials (RCT) through a qualitative approach.

BACKGROUND: During the past decades personality pathology was considered to have a negative influence on the outcome of pharmacotherapy of depressive disorders. Recently, there has been a shift towards a less negative opinion. Still, the evidence in the literature remains inconclusive. This may be explained by methodological differences between published studies.

Various medicines, which are collectively termed 'antiepileptic drugs', have been used to treat persistent aggression. This review systematically examines the evidence supporting this practice. From the evidence available, we were unable to draw any firm conclusion about using these medicines to treat aggression. Four antiepileptic drugs (valproate/divalproex, carbamazepine, oxcarbazepine and phenytoin) helped to reduce aggression in at least one study. However, for three of these drugs (valproate, carbamazepine and phenytoin) we found at least one other study where there was no significant improvement. Further research is needed to clarify which antiepileptic drugs are effective for whom. Such research is best carried out using carefully designed clinical trials. Such trials need to take account of the type of aggression displayed, the severity of the aggression, and any other disorders experienced by the participants.

The optimum treatment for Lennox‐Gastaut syndrome has yet to be established. Lennox‐Gastaut syndrome is a seizure (epilepsy) disorder that is commonly associated with behavioural and mental health problems. Many different treatments are currently used in the treatment of this disorder and many more have been tried in the past, often with little success. The review of trials found that there was no evidence to suggest that any one drug was more effective than another in the treatment of this disorder in terms of controlling the different seizure types. More research is needed to compare the therapies currently available.

Borderline personalitydisorder (BPD) is a complex and severe mental disorder that affects approximately 2% of the general population. Many people with BPD experience considerable instability in their interpersonal relationships and sense of who they are, leading to frequent crises and acts of self harm. To date, little is known about what might help people with BPD when they are experiencing an acute crisis. In this review, we wanted to examine how effective crisis interventions are for people with BPD by looking at evidence from randomised controlled trials (RCTs).

We considered eight studies, but none of them recruited participants solely on the basis of having antisocial personalitydisorder. While most studies included in this review looked at treatments to reduce drug or alcohol misuse in people with antisocial personalitydisorder, no study focused on treating the disorder itself. Studies varied in terms of choice of outcomes. While some studies reported outcome measures that were originally defined in the review protocol as being of particular importance in this disorder (for example, aggression, social functioning and adverse effects resulting from the use of medication), no study reported on reconviction.

Results of twelve studies, five RCTs and seven non‐RCTs including a control group, conducted in the USA, Canada and Great Britain suggest that Cognitive Behavioral Treatment (CBT) in residential settings is more effective than standard treatment in reducing criminal behavior in adolescents twelve months after release from the institution. The results are consistent across studies although the studies vary in quality. There is no evidence that the results of CBT are better than those of alternative treatments, i.e. treatments other than CBT.

We considered 11 studies, but were unable to draw any firm conclusions from the evidence available. Although several studies looked at treatments to reduce drug or alcohol misuse in people with antisocial personalitydisorder, few studies focused on treating the disorder itself. Only three studies reported outcome measures that were originally defined in the review protocol as being of particular importance in this disorder (reconviction and aggression). Nonetheless, there was some evidence that a type of treatment known as contingency management (which provides rewards for progress in treatment) could help people with antisocial personalitydisorder to reduce their misuse of drugs or alcohol.

People with borderline personalitydisorder often have difficulties controlling their emotions and impulses, and find it hard to keep relationships. They can experience feelings of emptiness, suffer quick changes in mood and they may harm themselves. Problems coping with abandonment and a rapidly changing view of other people can form part of their difficulties. All of these things make it hard for them to engage with any treatment they may be offered. Those who are able to engage often find it hard to stick with the treatment and leave before the end. Certain types of psychological treatment ('talking therapies') have been developed in recent years to help people with this disorder. This review summarises what is currently known about the effects of these treatments. It updates a review published in the Cochrane Database of Systematic Reviews in 2006.

This review assessed the effectiveness of drug therapy on groups of symptoms in patients with severe personalitydisorder, concluding that mood stabilisers deserved greater consideration, but caution was needed. There were some methodological limitations and the authors' recommendation for caution in interpreting the findings was appropriate.

The review assessed interventions provided by nurses for people with personality disorders. The authors found that the evidence was too weak to draw conclusions about the usefulness of nursing interventions. The review cannot support conclusions about whether one type of intervention is better than another.

This guideline has been developed to advise on the identification, treatment and management of the eating disorders anorexia nervosa, bulimia nervosa and related conditions. The guideline recommendations have been developed by a multidisciplinary group of health care professionals, patients and their representatives, and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high quality care for those with eating disorders while also emphasising the importance of the experience of care for patients and carers.

This guideline has been developed to advise on the identification, treatment and management of obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD). Although distinct disorders, OCD and BDD share a number of common features and there is a high degree of similarity between the treatments for the two conditions. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, people with OCD, a carer and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high quality care for those with OCD and BDD while also emphasising the importance of the experience of care for people with OCD, BDD, and carers.